| NPI | 1427130376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: KY 44260) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL2783) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD438299) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 44260) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-09-11 |